Abstract | An Objective Criterion For Determining The Prevalence Of Acute Peritonitis

Authors: Grynchuk F. F., Grynchuk A. F. Scientific advisor: Grynchuk F. V. M.D.

Department of Surgery №1

Bukovinian State Medical University

The prevalence of acute peritonitis (AP) is one  of the  most  disputable issues. Most foreign authors distinguish between diffuse,  total, and sometimes – subtotal one.  Ukrainian researchers often  distinguish between local, diffuse,  poured, and general one. However, some of them  consider it inappropriate to highlight a general type of AP. These differences are mainly due to the subjectivity of the assessment, which is mostly based on the visual definition of the peritoneum state. Therefore, it is relevant to have the best practice of the objective evaluation method.

In an experiment on 20  albino rats, we determined the width of the scattering zone (WSZ) of a laser beam with a wavelength of 0.63 µm of the inflammatory altered peritoneum. In group I (10 animals) AP was modeled by intraperitoneal insertion of sterile bile, in group II (10 animals) it was modeled by fecal matter. Before its modeling, in 6 and 12 hours afterward, we had determined the WSZ in different parts of the parietal peritoneum, which was then taken for histological examination. The data obtained before modeling AP served as the controlled one.

The  benchmarks of  WSZ were  individually  changeable.  In  6  hours the  WSZ increased significantly in both groups. The indicators in group II were statistically significantly above the ones in group  I. Histological examination of the peritoneum in group  I showed an aseptic inflammation, and in group II – a purulent one. In 12 hours in group I the WSZ increased significantly, and in group II it has not changed. There were no significant intergroup differences. The histological examination in both  groups showed some signs of purulent fibrinous inflammation. To eliminate individual variability, we determined the ratio of WSZ indicators of the affected area of the peritoneum to the healthy one.  The parameters of the  relative indicators were  common to have  a slight individual variability and statistically significant differences in the case of aseptic and septic AP during the first

6 hours. Later, the  relative indicators were  almost the  same. As a conclusion we can say that  the growth of the laser beam WSZ with a wavelength of 0.63 µm in the affected area of the peritoneum, compared to the healthy one,  indicates the presence of aseptic AP of 1.5-2 times. The increase of the WSZ twice as much  indicates the development of septic AP. We also studied the indicators of WSZ in 28 patients with various forms of septic AP. The absolute indicators of the WSZ of unmodified peritoneum were  statistically significantly less than  in AP  case. There  were  no  clear patterns associated with various forms of AP, although in the occurrence of purulent inflammation the WSZwas noticed as the largest one.

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